The Role of Interest Group in the Political Circumstances that Affect Health Policy Agenda Setting 2005 Outline Introduction Interest Groups in Health Care Reform Variety of Interests Interplay of Interest Groups Debate Resolution 3 . Interest Group in Modern Healthcare Context The role of interest groups in the political decision-making and setting of legislative agenda is traditionally evident in contemporary American politics . The US Congress has been always permeable to groups throughout its history , but changes in institutional arrangements , in the interest group universe , and in tactics have affected the extent and the manner of group influence , as well as the kinds of groups that are influential . In the area of health care and health policy , the role of various interest groups is exemplar . Similarly to interest groups representing other industries , health care interest groups develop their own tactics and strategies to lobby the legislatures : like all interest groups they can use either an “inside ‘ or“outside ‘ strategies and can lobby through the grassroots or employ direct lobbying . Practically ,the objectives of lobbying , available resources , and timing issues usually determine the tactics each health care interest groups employs to represent own interests in the legislature . The role of interest groups in health policy agenda setting has been particularly evident during the health care reform during the 1990s . It is important to emphasize that the changes in the health care followed the 1992 presidential election and were notable marked with the intense conflict over approaches to health care . This conflict logically resulted in the explosion of activities by interest groups to influence the complex federal policymaking processes related to the health care reform . During the early 1990s , the U .S . health care system was in the midst of a major transition to a new relationship between financing health care and the delivery of health care services . It began with the growth of health maintenance organizations (HMOs , partly spurred by the Health Maintenance Organization Act of 1973 , in the early 1970s in response to the concerns over health cost inflation . By the early 1980s ,with HMOs well established , new financing and delivery mechanisms called , among other things , preferred provider organizations (PPOs ,emerged to compete with the traditional health insurance plans , which had dominated since the 1930s . To this mix must be added the trend toward large corporations ‘ self-insuring their employees for health services rather than purchasing health insurance for them , spurred by medical inflation and passage of the Employee Retirement Income Security Act (ERISA ) in 1974 . Each of these developments unsettled old habits for consumers , providers , and employers . Consumers began to be presented with lists of providers who could be used within their employer-provided plans , with clear implications for the concept of free choice of physician providers were now confronted by a spectrum of financiers ,including traditional nonprofit and commercial insurance carriers , PPOs .HMOs , self-insured corporations , Medicare , and Medicaid , with economic leverage through new reimbursement methods and , in many cases , new demands on physicians to alter their style of practicing medicine and employers were…